In the early days of vaping, it was heralded as a way to help cigarette smokers quit and was believed to be a far healthier option. In 2015, a review by Public Health England suggested that using e-cigarettes was 95% less harmful than smoking tobacco, a statistic that went on to be widely touted.
Subsequent research has proved it to be inaccurate. Vaping has now been linked to lung inflammation and damage, as well as impaired blood vessel function and a worsening of asthma symptoms.
We know that it can negatively affect the developing brains of young people, leading to difficulties with memory and concentration, and an increasing likelihood of developing depression. Also some common vape flavours expose users to high levels of carcinogens and other harmful chemicals, although most likely fewer than there are in traditional cigarettes.
Now, a new study has cast more doubt on the idea that vaping is a significantly healthy choice. In tests designed to measure their capacity for exercise, young people who vaped performed worse than non-vapers. In fact, their performance was similar to that of young cigarette smokers.
Azmy Faisal, of the department of sports and exercises sciences at Manchester Metropolitan University, recruited 60 young people for the study, which was recently presented at the European Respiratory Society Congress. All had normal lung function, but 20 of them had been smoking for at least two years, 20 had been vaping for at least two years, and 20 were non-smokers and non-vapers.
“It was a challenge to find people who were only using cigarettes, as most said they also vaped regularly which tells you how popular it is among young individuals,” says Faisal.
Each participant took part in an incremental exercise test on a static bike. This is the gold-standard for testing physical fitness, looking at the responses of heart, lungs and muscles at harder and harder levels until they reach their maximum. Participants were also given blood tests and an ultrasound scan to analyse how well their arteries were functioning.
On average, the young vapers had lower peak exercise capacity (186 watts) than the group who did not vape or smoke (226 watts) and similar capacity to the group of smokers (182 watts). This is a measure of the maximum amount of physical exertion that a person can achieve. At peak exercise, vapers and smokers were less able to consume oxygen, compared to the non-smoking non-vaping groups.
Vapers and smokers showed signs that their blood vessels were not working as well as the non-smoking and non-vaping group, according to the blood tests and ultrasound scans. They also had higher levels of lactate in their blood, a sign of muscle fatigue, even before they reached their maximum level of exercise
“The smokers and the vapers had measurably excess breathing while using the exercise bikes,” says Faisal. “They found it harder to breathe and they were less fit overall. In this regard, our research indicated that vaping is no better than smoking.
“And these were all active individuals with an average age of 23. We don’t know what the outcomes would be among people who have a more sedentary lifestyle.”
While there is some evidence that vapes can be a helpful tool in quitting smoking, there is also data to show young vapers are at higher risk of going on to smoke.
The Generation Vape Project asked more than 5000 Australian teenagers about their vaping and smoking history from age 12 onwards. Those who reported vaping were five times more likely to try a cigarette, and the younger they were, the higher the risk of smoking.
Faisal is planning further research using MRI (magnetic resonance imaging) to find out more about the impact of vaping on the function of the heart, lungs and muscles. Still, he believes there is enough evidence that we need to be making greater efforts to help young people avoid or quit the habit.
“I think we should ban vaping for all adults and young people under 24,” he says. “We still don’t know what the long-term consequences are.”
